Philomena Colatrella, the CEO of Swiss insurer CSS Insurance, has stirred the lively debate around Switzerland’s rising cost of health insurance by proposing deductibles of CHF 5,000 and CHF 10,000 – deductibles set the amount people pay out of their own pockets before their insurance kicks in.

CSS Versicherung_source Facebook

Colatrella discussed the idea in an interview with Blick. The response to her comments was widely covered by Switzerland’s media, including by the broadcaster RTS.

Compulsory basic health insurance in Switzerland is provided by private companies, but the Swiss government sets most of the rules, including the choice of deductibles. Currently, the highest is CHF 2,500, which comes with a premium discount of up to 70% of the deductible.

In recent years Swiss healthcare costs have risen dramatically, leading to large hikes in insurance premiums, sparking much heated debate on how to tackle the problem – since 1996, premiums have risen by 169% – see chart below.

The government has been working on reducing costs and has made some progress on the cost of medicines.

It has been estimated that CHF 5,000 and CHF 10,000 deductibles would reduce the average monthly cost of Swiss health insurance by CHF 170.

Alongside the healthcare cost debate is one on changing behaviour. This argument assumes the more people pay out their own pockets the more responsible they become regarding their own health. High deductibles would encourage those who opt for them not to smoke, eat healthier food or take regular walks for example. In addition, for minor problems, more might skip going to the doctor and visit a pharmacy instead.

Colatrella said these higher deductibles would need to be combined with a fund that would receive some of the savings and use them to cover the health care costs of those unable to afford them.

Switzerland’s debate around where to set the balance between personal responsibility and cost sharing is far from over.